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hmm... not always. I would do rads even if it would pay below peds. ability to work from home and set up you own schedule is priceless for many people
Yeah I said “largely,” not “always.”
hmm... not always. I would do rads even if it would pay below peds. ability to work from home and set up you own schedule is priceless for many people
😡ask the internist who got reported by the patients fam even after spending an hour with them explaining things.
What is that?Heck, I’m onc & generally considered to have one of the most compliant and pleasant pts, at least according to anecdotes and opinions from my med school classmates and co-residents who chose other specialties. Still, it’s not rare to encounter such jerks. And the occasional case of “daughter-from-California” syndrome.
If you're asking about “daughter-from-California syndrome,” here’s wiki's answer: Daughter from California syndrome - WikipediaWhat is that?
I've never heard of this, but it took me less than half a second to recognize her/him and be like "oh yeah...that f***** b****".If you're asking about “daughter-from-California syndrome,” here’s wiki's answer: Daughter from California syndrome - Wikipedia
I've never heard of this, but it took me less than half a second to recognize her/him and be like "oh yeah...that f***** b****".
Epic smart phrase the forwards the message to your nurse saying "needs appointment".An even worse variant of this is “daughter/son from Colorado, who also happens to be an NP/PA/radiology tech/phlebotomist/whatever other uninformed medical professional”. Especially if daughter/son is a midlevel. I have a couple of these situations right now…I have visits with the patient and then a few days later get lengthy MyChart messages from daughter NP, questioning everything I’ve done and making it sound like I’m completely irresponsible and incompetent. However, daughter NP never seems to have time to join the pt at the visit, where all of their concerns could be addressed…and the pt themselves never wants all the interventions daughter NP insists they should have…
Epic smart phrase the forwards the message to your nurse saying "needs appointment".
Why can daughter NP send messages to you in MyChart? But I probably know the answer, she bulldozed mom into giving her the login info 🙁Oh I do. And then pt comes back for an appointment, minus daughter NP, and agrees to a tx plan which daughter NP again tries to question afterwards. Wash rinse repeat.
Lately I’ve stopped caring about it…daughter NP isn’t the patient at the end of the day anyway.
I think on the West Coast it is similarly called "The Daughter from New York / New England"I've never heard of this, but it took me less than half a second to recognize her/him and be like "oh yeah...that f***** b****".
More proof we've given people too much leeway. As physicians (well maybe me less so and others in fields like rads and derm) are compassionate, unlike other fields, but we need to take a page out of other fields or else we will continue to get walked on. Anytime you ask a lawyer or financial advisor a question and take their time you are billed for it! Now we answer people as if we are call centers for verizonWhy can daughter NP send messages to you in MyChart? But I probably know the answer, she bulldozed mom into giving her the login info 🙁
Time to start 3 additional pressors that cost 50k a pop STAT!My favorite is when that son/daughter becomes proxy decision-maker and then ignores all the documented prior express wishes of the patient, and while everyone dithers about unplugging the patient, the patient recovers just enough to be a human vegetable just like they always wanted, and sent to SNF. Although that's not as bad as when this happens and the patient is still able to experience some suffering rather than passing peacefully as they wanted.
It has very real consequences we have to just sit by and watch. That's the whole point of a physician being burnt out morally. Many of us have adjusted to some of this. But it's real and it is something to cope with. I wonder about the folks that deep down on some level don't find it upsetting in the slightest. I've met those docs and they scare me a little.
Why can daughter NP send messages to you in MyChart? But I probably know the answer, she bulldozed mom into giving her the login info 🙁
Yes, this happens because all the bad doctors are "too comfortable"It is saddening how easy it is for doctors to get too comfortable, copy paste documentation, and hardly look at the patient.
Didn't realize this was so recent for you guys, sorry you're going through this.I’m not chasing you. And please don’t take this personal. I don’t think most doctors are like this. I would like to believe the great majority aren’t. I am just putting myself on the family’s side for a second here, and just pointing out where their mistrust might come from. It is not fair to you, specially if you re one of the good ones, but sometimes families simply don’t know any better, and they have fear from prior past experiences.
I honestly don’t even know how I landed on this thread. My cousin’s issue is pretty recent, she is still admitted but improving. I don’t see the need to get into the details, but other doctors have agreed that the way his person handled the situation was actually not the standard of care at all.
For what is worth, I actually wished many times she was under the care of a hospitalist and not under the obstetrician care. We re lucky he consulted infectious disease, who took over her case alongside the general surgery team. But it did take almost 48 hours of her worsening to get there.
All you are saying is completely valid, but family mistrust does have roots somewhere.
I have the 10 years of study and training to understand that access, there is such a massive difference it is not even in the same ballpark.for those venting about families having chart access or whatever. wait until you have a loved one or parent who is ill. you will be 100% grateful for having chart and lab access, it makes the world of difference. once you have had a loved one who is seriously ill and in the hospital, you see things in a different light. i know it did for me, and I think i'm a better physician for it.
I never said there wasn't a difference, but when you are faced with the situation you can understand the importance of having access to the information.I have the 10 years of study and training to understand that access, there is such a massive difference it is not even in the same ballpark.
I don't mind generally, but I'd love at least a 24 hour wait before its released to them. I get quite irritated when I get Mychart messages about labs before I've even looked at them. NB: I address labs within 24 hours 99.9% of the time so its not like they're waiting 2 weeks.for those venting about families having chart access or whatever. wait until you have a loved one or parent who is ill. you will be 100% grateful for having chart and lab access, it makes the world of difference. once you have had a loved one who is seriously ill and in the hospital, you see things in a different light. i know it did for me, and I think i'm a better physician for it.
Hopkins Charges for mychart messages, i think it is $25-50 a message, they started about 2 years ago I believe. From some people I have spoken to, their mychart message burden has significantly decreased.
Hopkins Charges for mychart messages, i think it is $25-50 a message, they started about 2 years ago I believe. From some people I have spoken to, their mychart message burden has significantly decreased.
Are there any other institutions that do this? We should have a running list.Hopkins Charges for mychart messages, i think it is $25-50 a message, they started about 2 years ago I believe. From some people I have spoken to, their mychart message burden has significantly decreased.
Are there any other institutions that do this? We should have a running list.
Many do. But it's not as simple as "MyChart messages cost $25 to send". There are time requirements for billing MyChart messages and you have to get consent to do it. So, as I, and many, have mentioned before, any MyChart message that takes me longer to respond to than this question did gets an appointment scheduled at my convenience.Are there any other institutions that do this? We should have a running list.
I can count on 1 hand the number of MyChart messages I have spent 5 min or more on in the last 14+ years of practice. You get 2 or 3 lines, and after that, you're coming in.Per Hopkins website for patients:
When you initiate sending a message and select “Ask a medical question,” a pop-up notification will automatically display in MyChart. You can choose one of the following options in response:
How much will I be billed for medical advice through MyChart messages?
- If you agree to the terms in the pop-up, select “Next” and continue with your non-urgent MyChart message. If the clinician bills for their medical advice, it will appear in the “Visits” section of MyChart as an “eVisit,” with an after-visit summary just as it would for a video or in-person visit.
- Otherwise, decline and exit the messaging field. You can schedule an appointment if you prefer to have your question answered through an in-person or video visit.
Most MyChart messages are free. Clinicians may only bill for messages that require at least five minutes of time spent reviewing the medical record and providing medical advice. If you do not have insurance, out-of-pocket costs will range from approximately $15–$50, depending on the amount of time spent by your clinician. For most insurance plans, if your message is billed, you may not be charged at all or you may see a low out-of-pocket cost.
So basically regardless of patient getting charged or not, you can get paid for it.
If they keep on sending messages and its covered by their insurance, at least this way you can bill
I agree with GutOnc, anything more than a 5 min review definitely warrants a visit.
Rads is reading these threads and laughing all the way to the bank.I wish pathology or radiology were mandatory med school rotations, so I could've discovered them earlier.
If one doesn’t have kids then money is really a non issue. If one is single then it REALLY doesn’t matter. A single dude can easily spend next to no money and be happy.Ok, so what are you gonna do?
You may be taking things a little too personally. When patients threaten to complain, I encourage them to write down my name and spell it correctly on said complaint. My brain then moves on to the next thought, usually about by my golf swing, next guitar, or next whiskey purchase.
believe it or not, some of us actually enjoy clinical medicine and talking to patientsRads is reading these threads and laughing all the way to the bank.
They’re basically profiting massively off the behavioral degradation that is destroying clinical medicine. They get their imaging volume from entitled patients who demand advanced testing for every symptom while not having to deal with any of the blowbacks of ordering or not ordering studies.
My buddy is taking a job where he is going to sit at home 4 days a week from 5am to 1pm doing telerads. He will be making easily $500k doing this.
Anyone who could have gotten into rads but chose clinical medicine got bamboozled. Big time.
i enjoy talking to SOME patients. Overall, the negative encounters outweigh the good. It’s not that the bad encounters outnumber the good encounters. It’s that bad encounters leave a deeper scar on my psyche than good encounters provide positive reinforcement.believe it or not, some of us actually enjoy clinical medicine and talking to patients
encounters leave a deeper scar on my psyche
I don't mind it now and can basically block everything out, but my hatred for clinical medicine is basically irreversible at this point. The only reason I do this job is for the cash for FIRE. Once I'm done I'm done.You gotta learn to block it out man, just block it out.
Look, in any job that involves higher education and training (doctor, lawyer, engineer, etc), you're going to deal with a variety of personalities and idiots. Just short of actual physical trauma (rape, assault), most things you can learn to block out.
Yeah that is the frustrating part, by the time you learn to not let this stuff get to you you're likely already several years into practice.I don't mind it now and can basically block everything out, but my hatred for clinical medicine is basically irreversible at this point. The only reason I do this job is for the cash for FIRE. Once I'm done I'm done.
"Just take the abuse bro" I can assure you, everyone I know in engineering and law doesn't deal with even 1% of the bs clinicians have to deal with. All of my family and friends are in those fields and they essentially laugh at doctors for making a poor career choiceYou gotta learn to block it out man, just block it out.
Look, in any job that involves higher education and training (doctor, lawyer, engineer, etc), you're going to deal with a variety of personalities and idiots. Just short of actual physical trauma (rape, assault), most things you can learn to block out.
thousands of other ways to obtain this rather than from medicineYeah that is the frustrating part, by the time you learn to not let this stuff get to you you're likely already several years into practice.
That said, as I type this from a flat in Paris I'd say the clinical medicine work is worth it to be able to do stuff like this.
And we all could've FIRED much easier and quicker in tech, finance, engineering, the list goes on lolI don't mind it now and can basically block everything out, but my hatred for clinical medicine is basically irreversible at this point. The only reason I do this job is for the cash for FIRE. Once I'm done I'm done.
that hasn't been my experienceAnd we all could've FIRED much easier and quicker in tech, finance, engineering, the list goes on lol
If you want to FIRE the easiest you go to occupational school in high school and work a trade (preferably union) in a favorable COL area. Possible to do 6 figures by your mid to late 20s with benefits if you’re willing to work ain’t a screw up, zero debt. I know plenty of very successful people who can barely read.And we all could've FIRED much easier and quicker in tech, finance, engineering, the list goes on lol
If you want to FIRE the easiest you go to occupational school in high school and work a trade (preferably union) in a favorable COL area. Possible to do 6 figures by your mid to late 20s with benefits if you’re willing to work ain’t a screw up, zero debt. I know plenty of very successful people who can barely read.
22 years at $50k-$120k+ with low COL and compound interest? If they had enough financial literacy, certainly possible.How many of those trade workers have net worths approaching a couple million before 40 years old? Not uncommon for physicians.